Chemoprophylaxis for Neisseria meningitidis in an isolated Arctic community.
Community chemoprophylaxis with a regimen of sequential minocycline/rifampin (adults) or rifampin alone (children [less than 12 years of age]) was undertaken in a remote Arctic community one year after an outbreak of meningitis due to Neisseria meningitidis serogroup B. Nasopharyngeal carriage rates of N. meningitidis before prophylaxis were 32.4% in Inuit (Eskimos) and 6% in Caucasians, with maximal carriage (44.8%) in adolescents. Serogroup B accounted for 63.9% of all isolates before prophylaxis. One week after prophylaxis, the nasopharyngeal carriage rates were 0.8% in Inuit who had received prophylaxis and 33.3% in those who had not received prophylaxis (P less than 0.005). This reduction persisted at nine weeks after prophylaxis, when carriage rates were 1.2% in those who had received prophylaxis and 22.6% in individuals who had not received prophylaxis. Of the strains obtained before prophylaxis, 7.8% were sulfadiazine-resistant, whereas 35% of all isolates obtained from prophylaxis were sulfadiazine-resistant. Rifampin- or minocycline-resistant strains were not identified either before or after prophylaxis.
D000293:Adolescent; D000328:Adult; D001110:Arctic Regions; D002170:Canada; D002353:Carrier State / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D004930:Inuit; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000517:prevention & control*; D008826:Microbial Sensitivity Tests; D008911:Minocycline / Q000009:adverse effects / Q000627:therapeutic use*; D009305:Nasopharynx / Q000382:microbiology; D009345:Neisseria meningitidis / Q000145:classification / Q000187:drug effects*; D010349:Patient Compliance; D011159:Population Surveillance; D011247:Pregnancy; D012293:Rifampin / Q000009:adverse effects / Q000627:therapeutic use*; D012703:Serotyping; D013754:Tetracyclines / Q000627:therapeutic use*
D013754:Tetracyclines; D008911:Minocycline; D012293:Rifampin